Plastic surgery is simply applied anatomy, so you need to carefully analyze your anatomical problem. Fat alone is usually not an indication for the T-incision pattern abdominoplasty.
The vertical limb of the T is required as a seam to reduce the horizontal excess of skin. If you truly have excess ffat above the abdomen, you might consider a two-stage procedure with liposuction to reduce the fat, then assess the skin laxity to see if you need horizontal skin excision as would occur with patients with extreme weight loss.
In reality, the abdominoplasty is not an anatomically logical procedure since it places the skin naturally located above the belly button unnaturally below the belly button. It is merely the convenience of hiding the resultant incision in the panty-line that rationalizes the procedure.
Anatomically speaking, it makes more sense to pull the excess skin above the belly button upwards as in T incision tummy tuck. This more adequately addresses the looseness in the upper abdomen but requires an incision hidden in the inframammary fold of the breasts and sometimes requires the incision to go all the way across the lower chest thus making the central incision visible.
It becomes a trade-off between this incision and the visible vertical incision of the T-pattern. A second or even third opinion might be helpful. T incision tummy tucky is available but rarely used except in situations of extreme upper abdominal skin laxity. (Robin T.W. Yuan, MD, New York Plastic Surgeon)
T incision tummy tuck is not for everyone, see a qualified plastic surgeon
Obviously, as plastic surgeons, we seek the simplest and safest procedure that will yield the best cosmetic outcome. The best scar is no scar at all! Thus, to place an incision resulting in a scar that is в “T” shaped, there must be defined benefits to justify its use.
The use of a “T” incision is for the surgical excision of skin and fat in both the vertical and horizontal direction. This is often times seen in patients who have extreme excess and laxity of their anterior abdominal skin, such as in massive weight loss patients. The “T” incision is not for everyone, thus a thorough examination by a qualified plastic surgeon is advised. (Stephen A. Goldstein, MD)
Inverted T incision tummy tuck usually only for large amount of skin excess
The inverted Tor an even more extensive option called the Fleur De Lis abdominoplasty are great operations for patients who have alot of excess skin.
This is rare in most people, but is seen usually in patients after massive weight loss (~100lbs). Making the vertical incision helps to control the tension on the skin and remove excess skin in a horizontal as well as vertical direction.
The vertical incision is not usually needed to remove fat. That can be done through liposuction combined with an abdominoplasty. This procedure or combination of procedures can also be done in many different ways. I would get a second opinion. (Edward S. Lee, MD, Englewood Plastic Surgeon)
I have actually published about the inverted T tummy tuck (Plastic and Reconstructive Surgery Journal, volume 121, page 686, February, 2008). It is a very good operation for people who have lost more than 100 pounds (gastric banding or gastric bypass patients) and who therefore have a massive amount of hanging excess skin that has to be cut out.
But it leaves long and possibly prominent scars. This does not sound at all appropriate for you, the way that you describe your body. At most, it sounds like you need a conservative tummy tuck with a low scar at the level of your pubic hair. Any excess fat can be treated with liposuction (scarless) at the same time. (George J. Beraka, MD (retired), Beverly Hills Plastic Surgeon)
It is very rare to require a “T” incision.
My suggestion would be to get another opinion. It is very rare to require a “T” incision for abdominoplasty. Without pictures or examining you, it is hard to give more input for your particular case. However, unless you have an overabundance of skin and you are demanding the surgeon minimize the horizontal portion of the incision, you really should not need a “T” (David Shafer, MD, Houston Plastic Surgeon)
T-incision Tummy Tuck
As the abdominoplasty procedure evolves the incision lines change and go back to some of the original techniques. That is, not all tummy tuck patients are alike and sometimes a customized approach must be made to accommodate the patient and achieve the best cosmetic result. (Paul Vitenas, Jr., MD, Omaha Plastic Surgeon)